High Strength Opioid Formulations in Ontario: By the Numbers

Recently announced changes to the Ontario Drug Benefit (ODB) program in regards to reimbursement for high-strength long-acting opioids have elicited much discussion regarding their potential impact and implications in palliative care.

The ODPRN conducted a rapid analysis to inform current discussions on the utilizations of high strength formulations of long-acting hydromorphone, morphine and fentanyl and their usage among palliative care patients. The analysis reports prescribing trends in the ODB program between April 2014 and March 2015.

The analysis found:

More than 42 million long-acting opioid tablets or patches were prescribed during this time and reimbursed by the government.

Of those, almost 11% were high strength – the ones the Ontario government plans to stop funding, or “de-list” in January 2017.

Government-funded long-acting opioid tablets and patches were prescribed to 87,453 people in the year studied.

Of those, almost 16% had received at least one prescription for a high-strength opioid, or 13,695 people.

62,602 people received palliative care in Ontario over the study period.

In this population, 42.5% were treated with opioids that were reimbursed by the ODB program, but only 2.7% received high-strength opioids.

9/10 people in Ontario who receive government reimbursement for their prescription high-strength, long-acting opioid tablets or patches are not palliative care patients.